Palliative Care – Condition Information

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Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.

References: British Acupuncture Council evidence based factsheet about Palliative Care including specific research, trials and mechanisms of action for acupuncture in this condition.

Helen
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Dementia – Condition Information

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Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

Interpreting the research:

When reading health research, it is important to know that Systematic Reviews or Meta Analyses of a large number of high-quality research studies are the very best way to be able to say to what extent a given treatment can address a condition, symptom, or set of symptoms.  The next best level of evidence is the individual Randomised Controlled Study (RCT) which uses a systematic technique to compare two or more groups of patients receiving different treatments (or a treatment against a “control”, or no treatment).  In acupuncture trials, the nature of the control group is of particular interest as it is hard to blind a patient to whether they are having a needle inserted or not, and even more challenging to blind the researcher/team to this.

The means and quality of how research is carried out varies considerably from country to country, and in terms of how an intervention is compared to another intervention (or a control).  Of note is the fact that “sham” acupuncture (where needles are placed in apparently inert locations rather than traditional acupuncture points) is not really an inert process as it has physiological effects, so that comparing sham and “true acupuncture” may therefore not give a clear picture alone; but and form a part of a research body where acupuncture versus no treatment, vs conventional treatment or vs a different approach/modality also form part of the evidence base.

The n= figure (where quoted in research) tells you how many people were participants in the study, and usually the larger a study (when it is of good quality and design), the more likely it is to be reliable and applicable to larger populations. When (statistical) “significance” is discussed in view of studies it has a very particular meaning – it is the confidence in the data (using statistical tests) that tells us how likely a result could have just come about by chance. The lower the possibility of a chance result, the more likely it is due to the intervention in the experiment. When you are reading a trial/study, the “p” is the number telling us of significance, and this must be under 5% (or p less than 0.05) to mean we can say it is a (statistically) “significant” result.

The Research:

Zhi et al (2021; n=60) compared a vascular dementia group (VD) with a healthy control group to see if acupuncture can change the number and type of immune cells and molecules in the blood of patients with VD.  This wasn’t an RCT, as they did not have a VD control group, so the findings can be interpreted with caution.  They used blood tests to measure immune markers; Flow cytometry was used to count different types of immune cells, e.g. T cells, B cells, and natural killer (NK) cells. And ELISA was used to measure different inflammation markers, such as interleukins (IL), tumour necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ).

In Zhi et al’s study (2023), acupuncture was found to increase CD3+ T cells, CD4+ T cells, and regulatory T cells (Tregs) in the blood of patients with VD. These are types of immune cells that help regulate immune responses and prevent excessive inflammation.  Acupuncture treatment also decreased the level of TNF-α in the blood of patients with VD. TNF-α is a molecule that causes inflammation and can damage brain cells. The study concluded that acupuncture treatment may improve the immune system of patients with VD by changing the number and type of immune cells and molecules in the blood, the theory being that mediating neuroinflammation would be beneficial to VD patients.

References:

Zhi, H., Wang, Y., Chang, S., Pan, P., Ling, Z., Zhang, Z., Ma, Z., Wang, R. and Zhang, X., 2021. Acupuncture can regulate the distribution of lymphocyte subsets and the levels of inflammatory cytokines in patients with mild to moderate vascular dementia. Frontiers in Aging Neuroscience13, p.747673.

Resources:

British Acupuncture Council evidence based factsheet about Dementia including specific research, trials and mechanisms of action for acupuncture in this condition.

Helen
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